Mobile app delivered Mentalizing Imagery Therapy to augment remote family dementia caregiver skills training: a pilot randomized, controlled trial with outcomes assessment using digital phenotyping

项目总结/摘要 超过1500万美国人担任阿尔茨海默病（AD）和AD亲属的家庭照顾者。 相关性痴呆（ADRD）家庭照顾者往往经历高水平的压力和负担，导致 心理健康状况不佳，身体疾病的风险增加。国家老龄化研究所战略计划 确定了一个关键的优先领域，即需要制定更好的干预措施， 家庭ADRD照顾者的健康。本行政补充的目的是支持研究 费利佩·贾恩博士的培训，他是哈佛医学院的精神病学家。Jain博士是Paul B的接受者。 Beeson K76 Emerging Leaders in Aging Research职业发展奖，以表彰他在减少家庭暴力方面的研究。 使用移动的应用工具的ADRD护理人员压力和负担（心理化意象治疗实践， 正念练习和照顾者技能教育）。 护理人员使用教育和心理治疗移动的应用程序（App）显示， 在数周的时间里，参与度显著下降，这与移动的心理治疗的模式相似 普通大众的应用程序使用情况。美国国立卫生研究院行为改变科学计划旨在研究 促进长期采用健康行为的机制，例如参与减压 和护理人员技能工具。Jain博士进行的一项焦点小组研究， 护理人员发现，护理人员认为，由专家指导的同龄人异步聊天组 促进者将大大改善护理人员的支持和增加移动的应用程序的参与。 本补充提案将评估是否将新的便利聊天室功能集成到 带有护理人员工具的移动的应用程序改善了家庭ADRD护理人员的支持， 订婚该研究将描述优化移动的应用聊天室使用的功能。基于 习惯形成和动机理论，假设聊天室参与会增加长期- 与其他健康的移动的应用程序工具的互动。提高效率并缩短协调员的工作时间 对紧急聊天帖子的响应（例如那些反映生活中的人的攻击危险症状的帖子） 患有痴呆症，或照顾者有严重的心理症状，如自残的想法）， 将开发语言处理算法，最终可能向协调员发送快速警报。的 拟议中的研究将测试一种新的行为改变策略，以改善对家庭的心理支持 ADRD护理人员，提供专家指导的机会，并促进减压和护理人员 技能教育。

Project Summary / Abstract Over 15 million Americans serve as family caregivers of relatives with Alzheimer’s disease (AD) and AD- related dementias (ADRD). Family caregivers often experience high levels of stress and burden, resulting in poor mental health and increased risk of physical illness. The National Institute on Aging Strategic Plan identifies as a crucial priority area the need to develop better interventions to improve the mental and physical health of family ADRD caregivers. The purpose of this administrative supplement is to support the research training of Dr. Felipe Jain, a psychiatrist at Harvard Medical School. Dr. Jain is a recipient of the Paul B. Beeson K76 Emerging Leaders in Aging Research Career Development Award for his research to reduce family ADRD caregiver stress and burden using mobile application tools (mentalizing imagery therapy practices, mindfulness exercises and caregiver skills education). Usage of educational and psychotherapeutic mobile applications (Apps) by caregivers shows a significant drop-off in engagement over the course of weeks, a similar pattern to that of mobile psychotherapy App usage by the general population. The NIH Science of Behavior Change initiative aims to study mechanisms that promote long-term adoption of healthy behaviors, such as engagement with stress reduction and caregiver skills tools. A focus group study conducted by Dr. Jain with English and Spanish speaking caregivers found that caregivers believed that asynchronous chat groups with peers guided by an expert facilitator would substantially improve caregiver support and increase mobile App engagement. This supplement proposal will evaluate whether integration of a new facilitated chat room feature into a mobile App with caregiver tools improves family ADRD caregiver support and promotes long-term engagement. The study will characterize features that optimize usage of the mobile App chatroom. Based on habit formation and motivation theory, it is hypothesized that chatroom participation will increase long- engagement with other healthful mobile App tools. To improve efficiency and reduce time to facilitator response for urgent chat posts (such as those reflecting dangerous symptoms of aggression in the person living with dementia, or severe psychological symptoms in the caregiver such as thoughts of self-harm), a natural language processing algorithm will be developed that may ultimately send a rapid alert to the facilitator. The proposed research will test a novel strategy for behavior change that improves psychosocial support for family ADRD caregivers, provides opportunities for expert guidance, and promotes stress reduction and caregiver skills education.